This book is about change and how it works. It describes the phenomenon known as organizational ambidexterity, as derived from Jim March's (1991) landmark work on the subject. Organizational ambidexterity is a paradox, a simultaneous pairing of opposites, as in yin and yang. Here the yin represents incremental continual change while the yang represents novelty or radical and disruptive change. The formal names March (1991) proposed for these processes are exploration for the latter and exploitation in the former. Exploration and exploitation are essentially opposite strategies for organizational learning that organizations use to balance the 'right now' and 'what will be.' This book also explores how United States hospitals use exploration and exploitation and whether these elements affect their overall performance.